MEDICARE: PALM INTEGRATIVE FERTILITY, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1780542597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM INTEGRATIVE FERTILITY, PA

Provider Business Mailing Address
First Line	:	8340 VIA VITTORIA WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-5423
Country	:	US
Telephone Number	:	407-748-6461
Fax Number	:	917-451-6327

Provider Business Practice Location Address
First Line	:	180 AVENUE A SE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-6301
Country	:	US
Telephone Number	:	407-748-6461
Fax Number	:	917-451-6327

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JOSEPH B DAVIS
Credential	:	DO
Telephone Number	:	407-748-6461

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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